4 resultados para imperatives

em Scielo Saúde Pública - SP


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Enormous change and innovation in governmental practices are occurring throughout the world. Local governance, in particular, has become a concern in many countries. Processes such as redemocratization and decentralization and imperatives of international lending agencies have focused attention on developing good governance practices. Improvement in local government remains a high priority in most countries, but unless the relationship between citizens and government is more fully developed the actions of local government will not necessarily lead to improvement in the conditions of people's lives. This paper will explore the concept of governance and propose an analytical framework for the study of local governance in an international context. The article concludes with recommendations on strategies to improve governance systems and government performance.

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The hospital pharmacy in large and advanced institutions has evolved from a simple storage and distribution unit into a highly specialized manipulation and dispensation center, responsible for the handling of hundreds of clinical requests, many of them unique and not obtainable from commercial companies. It was therefore quite natural that in many environments, a manufacturing service was gradually established, to cater to both conventional and extraordinary demands of the medical staff. That was the case of Hospital das Clinicas, where multiple categories of drugs are routinely produced inside the pharmacy. However, cost-containment imperatives dictate that such activities be reassessed in the light of their efficiency and essentiality. METHODS: In a prospective study, the output of the Manufacturing Service of the Central Pharmacy during a 12-month period was documented and classified into three types. Group I comprised drugs similar to commercially distributed products, Group II included exclusive formulations for routine consumption, and Group III dealt with special demands related to clinical investigations. RESULTS: Findings for the three categories indicated that these groups represented 34.4%, 45.3%, and 20.3% of total manufacture orders, respectively. Costs of production were assessed and compared with market prices for Group 1 preparations, indicating savings of 63.5%. When applied to the other groups, for which direct equivalent in market value did not exist, these results would suggest total yearly savings of over 5 100 000 US dollars. Even considering that these calculations leave out many components of cost, notably those concerning marketing and distribution, it might still be concluded that at least part of the savings achieved were real. CONCLUSIONS: The observed savings, allied with the convenience and reliability with which the Central Pharmacy performed its obligations, support the contention that internal manufacture of pharmaceutical formulations was a cost-effective alternative in the described setting.

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"Science as culture" is based on the assumption that science is a valuable component of human culture. We therefore have to build the bridge, in cultural terms, from the scientific community to the common citizen. Teaching science as culture requires the co-construction of knowledge and citizenship. Ways of articulating science/technology with society are invoked, pondering on the ethical ambivalence of such connections. The goals of this reflection are to think about: a) epistemological obstacles that, in favouring the logic of monoculture, oppose the implantation of the science as culture; b) epistemological strategies that point towards a diversity of cultural practices and "constellations" of knowledge leading to the reconfiguration of the being through knowledge; c) imperatives that force us to (re)think the epistemological bases suited to the paradigmatic changes and which translate the dynamics and complexity of the evolution of the frameworks that currently sustain science and school scientific education.

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New pension programs in Latin America: lessons from the Argentinean experience. This work analyzes the political constraints of pension reform in Argentina. The first part presents a brief description of the development of pension programs in Latin America. Additionally, it also discusses the pension system crisis and the main proposals in order to overcome this crisis. The second part examines the peculiarities of the Argentine pension reform, with specific attention on economic imperatives and political constraints which have shaped the pension reform project of Menem´s Government (1989-1999). The article demonstrates that there are a large gap between the new system promises and its outcomes.